Category Archives: Health Care

I am convinced that the key to quality of life if our immune system. I have had this notion for the past 40 years after a discussion with my physician at the time who was an Internist. Not surprisingly the medical community, as a whole, has been stressing the importance of bolstering the immune system as an effective means of health maintenance. Additionally, immune therapy is being prescribed as a potential cure for numerous ailments and most recently as an alternative therapy for certain forms of cancer!

Here’s the problem. As is customary with the “American” strategy to solving problems we focus on addressing issues after they become a problem. Not only is this not effective, it becomes an extremely expensive burden on tax payers. While immune therapy may have benefits they tend to be short term. If the habits that led to the immune deficiency are not addressed then expensive immune therapy will be required indefinitely and the effectiveness will diminish over time.

The sescret to a healthy immune system, for the vast majority of our citizens, is ridiculously simple as well as cost effective:

30 minutes a day of effective exercise where a person elevates their rate to at least 50% above their “at rest” rate

&

Reducing caloric intake to no more than 2,500 calories per day. While there may be benefit to restricting consumption to certain items or food groups using the general guideline of not eating any one food in excess is almost as effective. This procedure will save most folks money.

I may have recommended viewing this video in prior postings, but I find it helpful to view it periodically: https://www.youtube.com/watch?v=aUaInS6HIGo. If you follow the recommendations your will have a significantly better quality of life.

The best and most cost-effective way to address any issue to focus “upstream”. Addressing solutions to causes works.

I recently read an ED OP in our local paper that was a reprint from apublication from a Minnesota paper. The writer was pointing out that while most EU countries were making positive progress to improve Life Expectancy, the US has been heading in the opposite direction for several years. The narrative stated that the CDC has placed part of the blame on drug overdoses and suicides. I did a bit of math on these areas and discovered that the increases in these areas has only had a minimal impact. The writer pointed out deficiencies in our health care system and noted increases in pregnancy mortality & heart disease, but again these numbers do not even come close to explainingaway the problem.

My opinion is that the issue lies with our broken and extremely expensivehealthcare system in combination with our inability (or unwillingness) tomaintain our immune systems through regular exercise and moderation of caloricintake. Our healthcare system costs, on average, 2 ½ times that per capita average for EU countries. Yet, according to the World Health organization weonly rank 31st in terms of quality of care. It is interesting tha this is exactly the rank that the US has with respect to Life Expectancy, again 31st. You would think that since we spend so much on health care we should begetting the best? I think it important to not befooled by Life Expectancy as a true measure of quality. The better measure isone termed HALE (Health Adjusted Life Expectancy). Following is taken from VeryWell Health: “How Is Healthy Life Expectancy Calculated? This is a bit complicated and uses lots of different data sources for each country. In a nutshell, the World Health Organization takes a country’s data like mortality rates and health status information and crunches them to look at things like how long people are expected to livewith about 135 health conditions. The calculation looks at the mortality ratefor different health conditions and adjusts it for the duration or severity of the illnesses.”

What this measures isyour expectation of a healthy life span, not just how long we can keep you alive! Again, we fall far behind the EU and in fact we fall to 35thoverall. The difference is significant. Currently our Life expectancy from birth stands at 79.3, but our HALE stands at only 69.1. Keeping us alive those additional 10 years is expensive and they are not our best years.

You might be surprised to learn that the following countries have a better HALE than the US: TheUnited Arab Emirates, Slovenia, Malta, Maldives, Costa Rica, Chile & Cuba. Our HALE is equal to that of China.

“Why a patient paid a $285 copay for a $40 drug

Two years ago Gretchen Liu, 78, had a transient ischemic attack — which experts sometimes call a “mini stroke” — while on a trip to China. After she recovered and returned home to San Francisco, her doctor prescribed a generic medication called telmisartan to help manage her blood pressure. Liu and her husband Z. Ming Ma, a retired physicist, are insured through an Anthem Medicare plan. Ma ordered the telmisartan through Express Scripts, the company that manages pharmacy benefits for Anthem and also provides a mail-order service.

The copay for a 90-day supply was $285, which seemed high to Ma.

“I couldn’t understand it — it’s a generic,” said Ma. “But it was a serious situation, so I just got it.” A month later, Ma and his wife were about to leave on another trip, and Ma needed to stock up on her medication. Because 90 days hadn’t yet passed, Anthem wouldn’t cover it. So during a trip to his local Costco, Ma asked the pharmacist how much it would cost if he got the prescription there and paid out of pocket. The pharmacist told him it would cost about $40 “I was very shocked,” said Ma. “I had no idea if I asked to pay cash, they’d give me a different price.” Ma’s experience of finding a copay higher than the cost of the drug wasn’t that unusual. Insurance copays are higher than the cost of the drug about 25 percent of the time, according to a study published in March by the University of Southern California’s Schaeffer Center for Health Policy and Economics. USC researchers analyzed 9.5 million prescriptions filled during the first half of 2013. They compared the copay amount to what the pharmacy was reimbursed for the medication and found in the cases where the copay was higher, the overpayments averaged $7.69, totaling $135 million that year.

USC economist Karen Van Nuys, a lead author of the study, had her own story of overpayment. She discovered she could buy a one-year supply of her generic heart medication for $35 out of pocket instead of $120 using her health insurance.”

I act as guardian for my mother who has both Medicare & Tricare coverage. I just received a detailed account of my mother’s medications for RX this year. There is an “*” on each line item. The note at the bottom of the statement reads as follows: “You can use home delivery from the TRICARE Mail Order Pharmacy for this medication and receive a 90 day supply for less than the 30 day supply co-pay from a retail pharmacy. Shipping is free……..”

I am shocked by this. As a tax payer you should be also. Obviously planned overpayments to pharmacies (with possible collusion by insurance companies) is horrible and in my view constitutes both fraud and an additional “tax” to consumers. However, keep in mind that these are examples were the Co-pay is higher than the retail value of the drug. This is not merely an “overpayment” but outright theft. The attempt at explanations, in my view, are ludicrous. I encourage you to form your own view by reading the entire article at: https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug